TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
Browse
13 results
Search Results
Article Determining the Factors Affecting the Satisfaction of Patient in Sedoanalgesia Due to Distal Radius Fracture in Emergency Department(Galenos Publ House, 2025-05-21) Ellidokuz, Hülya; Aksay, Ersin; Oray, Nese Colak; Özgür, Sefer; Güzelce, Mustafa Can; Colak, NeseIntroduction: Patients with distal radius fractures (DRF) are frequently admitted to the emergency departments (EDs). Reduction with procedural sedation and analgesia (PSA) and followed by plaster/splint are the treatment of choice. We aimed to determine the factors affecting the satisfaction in patients with DRF undergoing PSA. Methods: This prospective, observational, cross-sectional study included 70 patients with DRF. The socio-demographic features, comorbidities, level of satisfaction with PSA procedure, physical factors of the environment, physician and patient satisfaction were evaluated. PSA satisfaction scores “1, 2 and, 3” were grouped as “dissatisfied group” and “4-5” points as “satisfied group” with the Likert scale. Patient satisfaction was compared between the groups according to the satisfaction levels. Results: The median satisfaction level was found 4 (interquartile range 4-5). Their satisfaction with the given information about the PSA procedure and the cleanliness of the area where the procedure was performed was higher in the satisfied group than the dissatisfied group (p=0.014 and p=0.007, respectively). Also, as the level of residents of emergency physicians, the satisfaction of the patients increased (p=0.025). There was no significant difference between the groups in terms of age, gender, educational status, comorbidities, fracture type, additional injury, selected sedo-analgesic drugs, Richmond Agitation Sedation Scale and, complications (p>0.05). Satisfaction was high in all physicians. Conclusion: PSA procedure was satisfactory by a majority and can be performed safely in the ED. The residency period of the physician who performed the PSA, satisfaction with the given information about PSA and the cleanliness of the area were affecting the patient satisfaction.Article Which Measures and Parameters of Heart Rate Variability Analysis May Be Useful for Early Detection and Predicting Prognosis of Sepsis? a Systematic Review(Galenos Publ House, 2025-02-26) Ozel, Hasan Fehmı; Kazdağlı, HasanSepsis, kardiyovasküler, solunum ve termoregülasyon gibi sistemlerde patolojik değişikliklere neden olur. Bu değişiklikler de kalp hızı değişkenliğinde (HRV) alterasyonlara neden olur. Vital bulgularda veya hastalığın klinik sunumunda herhangi bir değişiklik olmasa bile, enfeksiyona bağlı olarak sempatik sinir sistemi aktivasyonu nedeniyle HRV parametreleri değişebilir. Bu sistematik derlemedeki amacımız, literatürü inceleyerek sepsise ilişkin HRV ölçümlerini ve parametrelerini sunmak ve bunların sepsisin şiddetini ve ölüm riskini tahmin etmedeki olası rolünü araştırmaktır. Veritabanları, Nisan 1996 - Mayıs 2023 tarihleri arasında İngilizce dilinde yayınlanmış sepsis üzerine HRV analizlerini insan çalışmalarını bildiren orijinal araştırma makaleleri için tarandı. Makale araması tamamlandıktan sonra, 79 makale daha ayrıntılı bir değerlendirmeye tabi tutulmak üzere seçildi ve bu makalelerin tam metinleri incelendikten sonra 13 makale kriterlere uygun olarak sınıflandırıldı. Her HRV parametrelerinin ortalama değerleri her çalışmanın örnek büyüklüğüne göre düzeltildi ve genel ortalamalar hesaplandı. İstatistiksel karşılaştırmalar Wilcoxon eşleştirilmiş diziler testi ile yapıldı. Toplam 1453 hastanın yer aldığı dokuz çalışma dahil edildi, ortalama yaş 64,24 yıl ve tüm katılımcıların %53,9’u erkekti. Dahil edilen çalışmaların hepsi zaman, frekans domain analizi gerçekleştirdi ve dört tanesi bu analizlere ek olarak doğrusal olmayan analizler gerçekleştirdi. Dokuz çalışmanın yedisini acil serviste ve ikisini hastanelerin yoğun bakım ünitelerinde gerçekleştirildi. Altı çalışma sağ kalanlar ile hayatını kaybedenler arasındaki parametreleri, üç çalışma ise sepsisin farklı şiddet seviyeleri arasındaki parametreleri karşılaştırdı. SDNN, RMSSD, SDNN, HTI, LFnu, HFnu, LF/HF oranı, SD1, SD2, eğilimsiz dalgalanma analizi (DFA)α1 ve DFAα2, sepsis sonucuyla ilişkili gibi görünmektedir. Bu nedenle, sepsisin erken teşhisi için bu parametrelerin izlenmesinin faydalı olabilir.Article Citation - WoS: 2Differences in the Differential Expression of Micrornas Between Patients With Familial Multiple Sclerosis and Those With Sporadic Multiple Sclerosis(Galenos Publ House, 2023-12-28) Güllüoğlu, Halil; Uysal, Hasan Armağan; Poyraz, Turan; Altun, Zekiye; Kaya, Derya; Özcelik, Pınar; İdiman, Egemen; Poyraz, TuranObjective: Multiple sclerosis (MS) is a heterogeneous disease with clinical and immunological features. Most MS cases occur sporadically, but a considerable proportion of patients have a family history of MS. The etiology and pathophysiology of MS remain unclear. Recent epidemiological and gene expression studies have indicated that dysregulation of microRNAs (miRNAs) may play a role in MS pathogenesis. This study aimed to evaluate the differential expression of miRNAs in sporadic MS (sMS) and familial MS Materials and Methods: This cross-section, single-center study was conducted in 20 FMS and 10 sMS patients and 8 healthy controls. The patients were in the remission. In total, 2,549 miRNA genes were screened in the blood mononuclear cells from the whole blood samples of MS patients depending on miRBase 21. Differential expression of miRNAs in MS patients was identified compared with the control group, and miRNAs with a fold change >= 2 were validated using reverse transcription-polymerase chain reaction. Differentially expressed miRNAs were then compared between FMS and sMS patients. Results: Initial findings showed that miR-5100 and hsa-miR-16-2-3p were increased and miR-432-3p was decreased in FMS compared with sMS, whereas miR-548-aa, hsa-miR-142-3p, and miR-451-b were increased in both sMS and FMS, but miR-548-v was increased only in sMS. Some miRNAs showed the same expression patterns in both groups. Conclusion: Differential expression of certain miRNAs may be a useful biomarker in the diagnosis of MS. This study showed that miRNAs may discriminate between FMS and sMS cases and MS subtypes, as indicated in earlier studies.Article New Lymph Node Parameters and a Comparison With the American Joint Committee on Cancer N-Stages in Breast Cancer(Galenos Publ House, 2023-08-01) Eliyatkin, Nuket Ozkavruk; Başkır, İnci; İşlek, Akif; Zengel, BahaBACKGROUND/AIMS: The N-stage of TNM systems considers only the number of metastatic lymph nodes (NMLN) in breast cancer (BC). However, new lymph node parameters refer to the number of harvested lymph nodes (NHLN) and negative lymph nodes (NNLN), which have had an increasing significance in the current literature. This study aimed to compare NHLN, NNLN, lymph node ratio (LNR), modified lymph node ratio (mLNR), and log odds of positive lymph nodes (LODDS) against the standard American Joint Committee on Cancer (AJCC) N-stage for the prognosis of BC patients. MATERIALS AND METHODS: This study was designed retrospectively. The socio-demographic data, clinical features, histopathological factors, treatment modalities, receptor status of BC, and lymph node related parameters (AJCC N, LNR, mLNR, LODDS) were identified. Then, lymph node related parameters were compared for cancer-related mortality (CRM), cancer recurrence, disease-free survival (DFS), and overall survival (OS). RESULTS: Eight hundred seven women who underwent surgery for BC were included in this study according to its eligibility criteria. The mean follow-up period was 113.34±74.85 (range: 6-378) months. The NHLN was 21.24±9.22, the NMLN was 4.85±7.38, the NNLN was 16.39±9.48, the LNR was 0.23±0.29, the mLNR was 5.38±7.38 and the LODDS was -0.74±0.80 on average. During the follow-up period, 42 (5.2%) patients had local recurrence, 188 (23.3%) had distant metastases, and 252 (31.2%) patients died due to BC. NMLN, LNR, mLNR, and LODDS were found to be significantly higher, and NNLN was significantly lower in those patients with cancer recurrence and CRM (p<0.001). AJCC N-stages, and also LNR, mLNR, and LODDS groups according to the calculated cut-off values, were significant for DFS and OS according to survival analysis. In Cox regression analysis, only LODDS was a significant independent risk factor for OS [p=0.014, heart rate (HR)=3.78, 95% confidence interval (CI) for HR: 1.30-10.94)]. CONCLUSION: The results indicated that LODDS was more successful compared to other lymph node staging systems, especially for OS. However, randomized prospective controlled studies with larger samples and homogeneous study groups are needed to create standard classification systems as alternatives to AJCC N.Article Cortical Thickness Alterations in Parkinson's Disease With Mild Cognitive Impairment(Galenos Publ House, 2023-07-03) Çavuşoğlu, Berrin; Hünerli, Duygu; Kıyı, İlayda; Çakmur, Raif; Yener, Görsev; Ada, EmelObjective: This study investigated cortical thickness differences and their relationships with cognitive functions in Parkinson's disease (PD) with mild cognitive impairment (MCI) and cognitively normal (CN). Materials and Methods: Twenty-two patients with PD-MCI, 23 with PD-CN, and 23 healthy controls with structural brain magnetic resonance imaging scans and complete neuropsychological tests were enrolled in this study. Cortical thickness analysis was performed using the Statistical Parametric Mapping 12 software package. Correlations with cognitive functions were examined. Results: Cortical thickness was significantly lower in the PD-CN and PD-MCI patient groups than in healthy controls in the left precuneus and isthmus-cingulate cortex, right pars orbitalis, insula, and lateral orbitofrontal cortex. In addition, the PD-MCI group also exhibited cortical thinning in the left superior temporal gyrus, transverse temporal cortex, supramarginal gyrus, and bilateral posterior cingulate cortex compared with healthy controls. Correlation analyses among cortical thickness and cognitive scores of PD also revealed moderate associations between memory and the posterior cingulate cortex; language and the precuneus; and executive functions and the insula and isthmus-posterior cingulate cortices. Conclusion: MCI in PD may be related to cortical alterations in the posterior cingulate cortex and the left temporoparietal cortex, which has been associated with subtle cognitive deficits in PD.Article Citation - WoS: 1Citation - Scopus: 1Comparison of Facial Palsy Cases Before and During the Pandemic Coronavirus Disease-2019(Galenos Publ House, 2023-06-23) Uysal, Hasan Armağan; Güllüoğlu, HalilObjective: The pandemic coronavirus disease-2019 (COVID-19) is caused by a novel type of coronavirus named severe acute respiratory syndrome coronavirus-2 and is rapidly spreading all over the world. In addition to various neurological symptoms, acute facial palsy was diagnosed as the main neurological symptom in some COVID-19 patients. The current study aimed to analyze the variation and any possible association in the case numbers or medical symptoms of patients with facial palsy before and during the COVID-19 pandemic.Methods: The clinical files of patients who were diagnosed with facial palsy in the Neurology Department of Medicalpoint Hospital, University of Economics Faculty of Medicine, Izmir were retrospectively investigated. To compare the facial palsy cases according to different periods, two patient groups were formed: before the COVID-19 pandemic and during the COVID-19 pandemic. The pandemic group was further divided into two subgroups as COVID-19-positive and COVID-19-negative patients to compare the effects of COVID-19 on facial palsy.Results: During the specified COVID-19 period (May 2020-January 2021) of the study, 38 patients were admitted to the hospital for facial palsy; 34 facial palsy patients were admitted in the same calendar period as the two previous years (May 2018-January 2019). There was no significant difference in the frequency of facial palsy between these two time periods. There were significant differences between before and during the COVID-19 pandemic groups regarding response to cortisone therapy (p<0.001), facial palsy grade (p<0.001), electromyography findings (p=0.005), denervation (p<0.001), and 6 months recovery (p<0.001) data. There were also significant differences between the COVID-19-positive and COVID-19-negative subgroups regarding response to cortisone therapy (p=0.015) and facial palsy grade (p=0.001).Conclusion: The current study findings support the possible association between the severity of the clinical course of facial palsy and COVID-19. Further studies are needed to prove a direct association between facial palsy and COVID-19.Article The Experience of Women Infected by the Covid-19 During Pregnancy: a Qualitative Study(Galenos Publ House, 2023-03-23) Ugurlu, Meltem; Kıratlı, Didem; Yavan, TülayObjective: To gain deeper understanding of experiences of pregnant women infected with coronavirus disease-2019 (COVID-19) during the Methods: This study, which was planned as a descriptive qualitative study, was performed out with 15 pregnant women infected with COVID-19. The data were collected between January 5th and March 15th, 2021 using a semi-structured interview form and in-depth interview method. Content analysis, one of the qualitative research method, was used to evaluate the data. The research was planned based on the Qualitative Research Reporting Consolidated Criteria checklist, which is a guide for qualitative research. Results: Four main themes were found in experiences of pregnant women infected with COVID-19: (1) psychosocial health; (2) change in daily routines on quarantine days, (3) coping and (4) perinatal period changes. Pregnant women experienced both psychological and physical difficulties. They used the expression closed box to describe the anxiety and anxious state experienced due to the uncertainty of the perinatal outcomes brought about by COVID-19 during pregnancy. Conclusion: Understanding the experiences of pregnant women infected with COVID-19 is the first step in determining treatment and care management for nurses and healthcare professionals. During the pandemic period, pregnant women need to reach prenatal care services on time, to support them physically and psychosocially, to provide information with e-health services, and to provide remote follow-up support to cope with the process.Article Citation - WoS: 6Citation - Scopus: 10Comparison of Bpap S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: a Randomized Controlled Trial(Galenos Publ House, 2021-09-22) Gören, Nurfer Zehra; Sanci, Emre; Coskun, Feride Fulya Ercan; Gursoylu, Duygu; Bayram, BasakBackground: There is limited research into the utility of average volume-assured pressure support (AVAPS), a volume-assured pressure-controlled mode, especially in patients with hypercapnic respiratory failure. Aims: This study aimed at a randomized comparison of AVAPS and bilevel positive airway pressure spontaneous/timed (BPAP S/T) modes in non-invasive mechanical ventilation (NIMV) application with hypercapnic respiratory failure patients in the emergency department (ED). Study Design: Randomized controlled study. Methods: In this prospective randomized controlled study, 80 patients admitted to ED with hypercapnic respiratory failure requiring NIMV were randomly assigned to AVAPS or S/T groups using the sealed envelope method (33 patients in the S/T group, 47 patients in the AVAPS group). Data of arterial blood gas (ABG), vital parameters, Glasgow Coma Score (GCS), additional treatment needs, and clinical outcomes were evaluated, and the treatment success rates of both groups were compared. Results: A total of 80 patients, 33 in the S/T and 47 in the AVAPS group, were analyzed in the study. The pH values improved in the AVAPS group compared to the baseline (0.07 [0.04-0.10] vs 0.03 [0.00-0.11]). PaCO2 (partial pressure of carbon dioxide) excretion was faster in the AVAPS group than in the S/T group in the first hour (10.20 mmHg [6.20-19.20] vs. 4.75 ([-] 0.83-16.88)). The comparison of blood gas measurements showed no significant differences between the groups regarding the changes in PaCO2 and pH values over time (P=.141 and P=.271, respectively). During the ED follow-up, 3 (6.4%) patients in the AVAPS group and 5 (15.2%) patients in the S/T group needed intubation [Relative risk: 0.42 (95% CI: 0.11 to 1.64), P=.21]. Conclusion: In this study, improvements in blood gas parameters in the AVAPS group were faster compared to the S/T group; however, we did not find any significant difference between the groups in terms of clinical parameters. The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.Article Citation - WoS: 2Paramedian Forehead Flap in Large Nasal Skin Defects: Twenty-years' Experience(Galenos Publ House, 2022-11-15) Apaydin, Fazil; Kaya, Isa; Uslu, Mustafa; Berber, VeyselObjective: Skin cancers occur most commonly in the head and neck region where the nose is the most commonly affected unit. The nose is the part of the face that is most exposed to trauma, sunlight, and other environmental factors. From the aesthetic and functional point of view, reconstruction of the defects occurring after skin cancer removal creates a great challenge for the surgeon. In this retrospective study, we present the success rates achieved in the past 20 years with paramedian forehead flaps used for repairing large defects of the nose.Methods: The study included 62 patients who underwent paramedian forehead flap due to nasal skin tumor [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)] in Ege University Faculty of Medicine Otolaryngology Department between 2000 and 2020. Data on follow-up time, patients' age and gender, defect sizes, and tumor types were obtained retrospectively from patient files, histopathologic examination results and patient photographs. Additional diseases such as diabetes, hypertension, and coronary artery disease that could affect flap success, were noted.Results: Out of 62 patients 29 (46.8%) were female and 33 (53.2%) were male. Their mean age was 61.4 (range: 46-88) years. Mean follow-up period was 125.6 (8-244) months. Of the 62 patients 33 (53.2%) were operated on for BCC and 29 (46.8%) for SCC. Four patients (6.5%) had recurrences during their follow-up. There was no loss of the paramedian forehead flap.Conclusion: Paramedian forehead flap is a reliable option in the reconstruction of larger defects of the nose even in smokers and elderly patients who have comorbid diseases.Letter In Response To Comment on Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure Its Early Use in the Emergency Department(Galenos Publ House, 2021-03-15) Goren, Nurfer[Abstract Not Available]